Report on 2015 national survey of GP trainees and recent GP graduates

The Irish College of General Practitioners (ICGP) which represents over 90% of GPs in Ireland and is responsible for standards and training in general practice, today, Tuesday 6th October, published its latest trainee and graduate survey which indicates that over 10% of trainees are definitely planning on emigrating on completion of their specialist training in general practice, and of those committed to staying, worrying proportions find the financial and employer responsibilities of being a principal/partner GP unattractive.

The survey, entitled 'Bridging the gap – How GP trainees and recent graduates identify themselves as the future Irish general practice workforce', is an update on research undertaken by the ICGP in 2014. Two separate surveys were undertaken in March 2015. An online survey was emailed to all 668 current GP trainees with a reminder issued one week later. An online survey was emailed to all 576 GP graduates between 2010 and 2014 with a reminder issued one week later. Overall, 242 GP trainees responded representing a 36.2% response rate, while 197 recent graduates responded representing a 34.2% response rate. Response rates are typical of these groups.

Dr Claire Collins, ICGP Director of Research, said:

"Medical workforce planning remains topical and we consider that the data reported here by GP trainees and recent graduates may inform these discussions. We surmise that there is still a GP workforce planning concern with a worryingly low percentage of current trainees and recent graduates definitely committed to working in Ireland, and a large proportion of both trainees and recent graduates having a desire to work more flexibly and less than full-time in the future."

Dr Gerard Mansfield, ICGP Director of Training, said:

"The Irish population's general practice healthcare is at risk of a chasm developing between the traditional comprehensive role of the established GP, and the desires and expectations of the future general practice workforce. It is the shared responsibility of all involved in service and workforce planning to endeavour to construct a 'bridge' to help our specialty trained general practitioners transition from training to establishment as a principal clinician in practice."

In discussing the findings of the research, Dr Mansfield said:

"We are encouraged by the increase in the number of general practice trainees who have expressed their commitment to working in Ireland post qualification (2015:33%, 2014:28%). However, what is worrying from a workforce planning perspective is the unattractiveness to emerging general practitioners of undertaking, on behalf of the state, responsibility for premises, practice management, administrative staffing and information technology in order for there to be a general practice service. The state is funding more clinical care built upon an infrastructure it procures but does not own or control. It does not afford the security of employee status to anyone within this infrastructure and is completely dependent on GPs choosing to take up a contract for service from the state.

"With expanding co-morbidities and an ageing population, the demand for GP services in Ireland is expected to continue to increase. The workforce in general practice is a major concern for the government as they seek to move additional services into general practice and the community."

Key findings from the trainee survey:

• Over half of current trainee respondents are still undecided as to whether they will emigrate stating undecided or possibly, while 13.1% of current trainees are definitely planning to emigrate. This leaves one third planning to definitely stay in Ireland. However, this represents a slight improvement compared to 2014 (28%).
• When we look at reasons for considering emigration, under 20% cited the viability of general practice compared to 35% in 2014, while financial prospects is now the leading concern (35.7%).
• Less than half (46%) of trainees see themselves working full-time five years post training and this decreases further at 10 years post training (40%).
• While over half of trainees indicated a preference to work in a practice that is part of a primary care team, almost one-fifth are undecided. Less than two in five have a preference to be co-located with a primary care team in a primary care centre.
• The majority (85%) support the move of more chronic disease management into general practice if appropriately resourced and supported.
• Significant proportions of trainees find the financial and employer responsibilities of being a principal/partner GP unattractive.
• The majority (90.4%) of trainees who responded thought that the ICGP should be involved in determining the evolution of the role of general practice.

Key findings from the GP graduate survey:

• Similar to 2014, nine out of 10 recent graduates are still working in general practice. A total of 16.5% are currently working overseas and of this group, one quarter are planning to return to Ireland to work, an increase compared to 17% in 2014.
• Of those still in Ireland, one quarter definitely or possibly plan to emigrate in the near future. Among the reasons for considering emigration, the viability of general practice (25.6%) is predominant but is equalled by financial reasons. In 2014, almost 43% of recent graduates considering emigration cited viability of general practice as the key reason.
• Again, we see that being a single-handed GP is not a preferred or anticipated career end point.
• With regard to productivity, approximately one third of recent graduates are currently working less than eight half day sessions per week but almost half see themselves doing so within the next five years.
• While over half of recent graduates indicated a preference to work in a practice that is part of a primary care team, almost one-fifth are undecided. Less than one third have a preference to be co-located with a primary care team in a primary care centre.
• The majority (over 80%) support the move of more chronic disease management into general practice if appropriately resourced and supported. The majority (92.9%) of recent graduates thought that the ICGP should be involved in determining the evolution of the role of general practice.

Click here for the full report